Water Baptism Registration Form

Ready to go public with your faith?

Baptism is your next step after saying “yes” to Jesus. It’s a public declaration of the life change He’s already done in you. Let’s celebrate it—together. Date: Sunday, June 8 | Location: Ogan's Landing | Time: Following our second service
Name*

First NameLast Name
E-mail
Phone*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date

MonthDayYear
T-Shirt Size*
If under 18: Parent's Name
Have you accepted Jesus Christ as your Lord and Savior?

YesNot yet, but I would like to talk with somone
Tell us a little bit about your story or why you want to be baptized
Do you need someone to reach out and walk you through what to expect?

YesNo, I'm good
I give permission for Walnut Street Church to use our pictures in their media and advertising.

YesNo
Should be Empty:

Ready to go public with your faith?